MEDICARE: DR. PETER NOCK DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	34.007711	OH
2	208M00000X	Hospitalist Physician	0102205117	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578561361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER NOCK DO

Provider Business Mailing Address
First Line	:	PO BOX 79777
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21279-0777
Country	:	US
Telephone Number	:	434-654-7794
Fax Number	:	434-654-7582

Provider Business Practice Location Address
First Line	:	500 MARTHA JEFFERSON DR
Second Line	:
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22911-4668
Country	:	US
Telephone Number	:	434-654-7580
Fax Number	:	434-654-7582

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	10/09/2020

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Directions to “ DR. PETER NOCK DO” Practice Location

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